No abstract available.
Heel* ; Molluscum Contagiosum* ; Weight-Bearing* ; Zea mays

No abstract available.

Purpose: This study was conducted to determine which factors influence the ability of abdominal ultrasonography (US) to detect focal pancreatic lesions identified using endoscopic ultrasonography (EUS). Methods: In this study, 338 consecutive patients with focal pancreatic lesions (cyst, n=253; adenocarcinoma, n=54; pancreatic neuroendocrine tumor, n=24; solid pseudopapillary neoplasm, n=4; intrapancreatic accessory spleen, n=1; metastasis, n=1; and lymphoma, n=1) detected by EUS who underwent US were enrolled. We reviewed their radiologic reports and assessed the presence or absence of a focal lesion, the multiplicity of the lesions, and their size and location on US. We evaluated how these parameters differed depending on whether the lesion was solid or cystic. Univariate and multivariate logistic regression analysis were performed. Results: The overall detection rate of focal pancreatic lesions by US was 61.5% (208 of 338). Using US, the detection rate of cystic lesions was 58.5% (148 of 253), while that of solid lesions was 70.6% (60 of 85). In the univariate analysis, location in the neck or body, solid characteristics, and a relatively large size (15.50±10.08 mm vs. 23.09±12.93 mm) were associated with a significantly higher detection rate (P<0.001, P=0.047, and P<0.001, respectively). In the multivariate analysis, location in the neck or body (odds ratio [OR], 3.238; 95% confidence interval [CI], 1.926 to 5.443; P<0.001) and size (OR, 1.070; 95% CI, 1.044 to 1.096; P<0.001) were proven to be significant predictors of detectability (P<0.001). Conclusion US is useful for detecting focal pancreatic lesions, especially when they are located in the neck or body and are relatively large.

PURPOSE: The goals of cranioplasty are to protect the brain from trauma and restore normal cranial contour with as few complication as possible. In patient who suffered from cranial defect, the most satisfactory form of cranioplasty may be archived with autogenous bone grafts. We report on the treatment of large frontal bone defect using pericranial flap and split-rib graft. METHODS: A 29-year-old male was referred to our department. He was involved in an automobile accident resulting in large frontal bone and sinus defect and skull basal defect. The reconstruction was undertaken using galeal frontalis myofascial flap and split-rib cranioplasty using bicoronal incision. RESULTS: The postoperative course was successful. For 9 months follow up period, there was no complication about hematoma, infection, CSF leakage and washboard deformity. He was pleased with the results even when absolute symmetry was not achieved. CONCLUSION: We experienced large frontal bone and sinus defect and skull basal defect patient and successfully treated with split-rib graft and galeal frontalis myofascial flap.
Adult ; Automobiles ; Brain ; Congenital Abnormalities ; Follow-Up Studies ; Frontal Bone ; Hematoma ; Humans ; Male ; Skull ; Transplants

BACKGROUND AND PURPOSE: A population-based door-to-door study of cross-sectional methods for assessing the prevalence and factors related to a high risk of obstructive sleep apnea (OSA) was conducted using the Korean version of the Berlin Questionnaire (K-BQ). METHODS: Pooled data collected from Community Health Surveys by the Korea Center for Disease Control and Prevention were analyzed. Of 8,140 respondents from the population, 7,955 were finally included in this study. RESULTS: Of the 7,955 included subjects, 15.7% of the men and 9.8% of the women were at high risk of OSA. Significant differences were found in the following factors between the subjects with a high risk of OSA: gender, age, marital status, educational level, occupation, and presence of smoking, harmful alcohol use, and chronic diseases. Male sex, harmful alcohol use, and the presence of chronic diseases were identified as factors independently associated with a high risk of OSA. CONCLUSIONS: This is the first study to confirm the usefulness of the K-BQ to study the prevalence of OSA in the Korean general population. The findings demonstrate that harmful alcohol use and chronic diseases are very common characteristics among those with a high risk of OSA.
Berlin ; Centers for Disease Control and Prevention (U.S.) ; Chronic Disease ; Surveys and Questionnaires ; Epidemiology ; Female ; Health Surveys ; Humans ; Korea ; Male ; Marital Status ; Methods ; Occupations ; Prevalence* ; Sleep Apnea, Obstructive* ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND/AIM: Nitric oxide (NO), the nonadrenergic, noncholinergic inhibitory neurotransmitter, plays a role in controlling esophageal motor function by causing guanosine 3', 5'-cyclic monophosphate (cGMP) accumulation in circular smooth muscle of the esophagus and lower esophageal sphincter (LES). Increase in the intracellular concentration of cGMP as a second messenger produces relaxation of smooth muscle. It is metabolized by phosphodiesterase (PDE). Sildenafil, a drug used to improve the functional impotence, shows an inhibitory effect on the smooth muscle cells of the human corpus cavernosum by blocking type V PDE that destroys cGMP. The aim of this study was to investigate the effects of sildenafil on the esophageal motility. METHODS: Eight male subjects without any evidence of esophageal motor dysfunction were enrolled in this study. On first day, 20 ml of distilled water (placebo) was infused into the stomach. On second day, 0.8 mg/kg of sildenafil powder dissolved in water was infused into the stomach. We measured the amplitude of esophageal body contractions and LES pressure at each day. In addition, plasma cGMP levels were assayed by ELISA method. RESULTS: There were no significant differences in esophageal manometric findings in the placebo group, but significant decreases in LES pressure as well as amplitude of peristaltic contractions at smooth muscle portion of esophagus were noted in sildenafil group. Sildenafil showed its maximum effect in lowering LES pressure on 30 minutes after ingestion, and also in decreasing the amplitude of peristaltic contractions at smooth muscle portion of esophagus on 15 minutes after ingestion. There was no difference in the propagation velocity of peristalsis and plasma cGMP levels after sildenafil treatment. CONCLUSION: Sildenafil showed inhibitory effects on smooth muscle of esophageal body and LES in human.
Eating ; Enzyme-Linked Immunosorbent Assay ; Erectile Dysfunction ; Esophageal Sphincter, Lower ; Esophagus ; Guanosine ; Healthy Volunteers* ; Humans ; Male ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Neurotransmitter Agents ; Nitric Oxide ; Peristalsis ; Plasma ; Relaxation ; Second Messenger Systems ; Stomach ; Water ; Sildenafil Citrate

No abstract available.
Child* ; Humans

PURPOSE: To assess the effect of a rectal enema on interfraction prostate movement in bone alignment (BA) for prostate radiotherapy (RT), we analyzed the spatial difference in prostates in a bone-matched setup. MATERIALS AND METHODS: We performed BA retrospectively with data from prostate cancer patients who underwent image-guided RT (IGRT). The prostate was identified with implanted fiducial markers. The setup for the IGRT was conducted with the matching of three fiducial markers on RT planning computed tomography images and those on two oblique kV x-ray images. Offline BA was performed at the same position. The coordinates of a virtual prostate in BA and a real prostate were obtained by use of the ExaxTrac/NovalisBody system, and the distance between them was calculated as the spatial difference. Interfraction prostate displacement was drawn from the comparison of the spatial differences. RESULTS: A total of 15 patients with localized prostate cancer treated with curative hypofractionated IGRT were enrolled. A total of 420 fractions were analyzed. The mean of the interfraction prostate displacements after BA was 3.12+/-2.00 mm (range, 0.20-10.53 mm). The directional difference was profound in the anterior-posterior and supero-inferior directions (2.14+/-1.73 mm and 1.97+/-1.44 mm, respectively) compared with the right-left direction (0.26+/-0.22 mm, p<0.05). The required margin around the clinical target volume was 4.97 mm with the formula of van Herk et al. CONCLUSIONS: The interfraction prostate displacement was less frequent when a rectal enema was performed before the procedure. A rectal enema can be used to reduce interfraction prostate displacement and resulting clinical target volume-to-planning target volume margin.
Enema* ; Fiducial Markers ; Humans ; Prostate* ; Prostatic Neoplasms ; Radiotherapy* ; Retrospective Studies

PURPOSE: Deteriorated nutritional status is common during a hospital stay for esophagectomy in patients with esophageal cancer. Malnutrition in those patients is often marked compared with other gastrointestinal cancer. The purpose of this study is to evaluate the appropriateness of commercial peripheral parenteral nutrition (CPPN) use in patients who underwent Ivor-Lewis esophagectomy (I-L op). METHODS: Patients who were provided with CPPN after I-L op were enrolled in this study from January to May 2015. Body weight, height, nutritional status, length of hospital stay, duration of CPPN therapy, and parenteral nutrition (PN) induced complications were assessed, respectively, using electronic medical records. RESULTS: Thirty-nine patients were enrolled. Average age was 65.9 years and 36 patients were male. All patients were provided with the same CPPN. The duration of fasting and CPPN use was 5.8+/-1.4 days and 7.5+/-1.8 days, respectively. Calorie supported by CPPN was 22.6+/-3.5 kcal/kg/day and only 20.5% of patients (n=8) reached the daily target calories. Most frequent PN induced complication was phlebitis which occurred in 8 patients (20.5%). Calcium, magnesium, and transthyretin levels in serum were not monitored during the PN support period. CONCLUSION: The indications for CPPN were appropriate because the fasting duration in patients with I-L op was 5 to 10 days. Although a large portion of patients could not be supplied daily target calories, their nutrition status was not significantly changed on admission and at discharge. We did not find it necessary to individualize PN support for a short period after an I-L op in patients with esophageal cancer. Further study will be needed to determine why the incidence of phlebitis was dominant.
Body Weight ; Calcium ; Electronic Health Records ; Esophageal Neoplasms* ; Esophagectomy* ; Fasting ; Gastrointestinal Neoplasms ; Humans ; Incidence ; Length of Stay ; Magnesium ; Male ; Malnutrition ; Nutritional Status ; Parenteral Nutrition* ; Phlebitis ; Prealbumin

Henoch-Schonlein Purfrura is a generalized small vessel vasculitis of hypersensitivity type characterized primarily by a purpuric skin lesion, renal involvementwith hematuria and proteinuria, arthralgia, and colicky abdominal pain. A possible neurologic involvement was recognized in 1914 by Osler. A case of a 7 1/2-year-old male patient with Henoch-Schonlein purpura developed neurologic manifestations including seizure and mental status change. The cranial CT demonstrated a occipital hemorrhage of right side and cerebral edema with contrast enhancing scattered dilated vessels. The EEGchanges were slow wave activities in acute stage. The follow-up EEG shows that the slow wave activities were more improved than previous and that multiple spike waves were recorded at bothfronto-temporo-parietal areas with phase reversals. The vasculitis of HenochSch6nlein purpura can involve the nervous system.
Abdominal Pain ; Arthralgia ; Brain Edema ; Cerebrum* ; Electroencephalography ; Follow-Up Studies ; Hematuria ; Hemorrhage ; Humans ; Hypersensitivity ; Male ; Nervous System ; Neurologic Manifestations ; Proteinuria ; Purpura ; Purpura, Schoenlein-Henoch* ; Seizures ; Skin ; Vasculitis